title: Indications for hematopoietic stem cell transplantation in patients with follicular lymphoma: a consensus project of the EBMT-Lymphoma Working Party.
abstract: The aim of this project was to define indications for hematopoietic stem cell transplantation in follicular lymphoma in Europe. In the absence of evidence-based data, a RAND-modified Delphi procedure was used by an expert panel. After pre-defining statements, these were individually/anonymously scored by each participant using a 9-point scale. Consensus was reached that: 1) high-dose therapy with autologous stem cell rescue is not an appropriate option to consolidate first remission in patients responding to immuno-chemotherapy outside clinical trials; 2) in patients with first chemo-sensitive relapse, high-dose therapy with autologous stem cell rescue is an appropriate option to consolidate remission, especially in patients with a short response after immuno-chemotherapy or with high-risk FLIPI; 3) high-dose therapy with autologous stem cell rescue is also appropriate in second/subsequent chemo-sensitive relapses; 4) allotransplant (preferably a reduced intensity conditioning-allotransplant) should be considered at relapse after high-dose therapy with autologous stem cell rescue. No consensus was reached on the role of high-dose therapy with autologous stem cell rescue in low-risk first relapse, or on when an allotransplant should be preferred over high-dose therapy with autologous stem cell rescue. In the absence of evidence-based data, the consensus method used was a valuable tool to define indications for hematopoietic stem cell transplant in follicular lymphoma.
authors.affiliation: Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK. s.montoto@qmul.ac.uk
authors.forename: Silvia
authors.initials: S
authors.lastname: Montoto
authors.forename: Paolo
authors.initials: P
authors.lastname: Corradini
authors.forename: Martin
authors.initials: M
authors.lastname: Dreyling
authors.forename: Michele
authors.initials: M
authors.lastname: Ghielmini
authors.forename: Eva
authors.initials: E
authors.lastname: Kimby
authors.forename: Armando
authors.initials: A
authors.lastname: López-Guillermo
authors.forename: Stephen
authors.initials: S
authors.lastname: Mackinnon
authors.forename: Robert E
authors.initials: RE
authors.lastname: Marcus
authors.forename: Gilles
authors.initials: G
authors.lastname: Salles
authors.forename: Harry C
authors.initials: HC
authors.lastname: Schouten
authors.forename: Anna
authors.initials: A
authors.lastname: Sureda
authors.forename: Peter
authors.initials: P
authors.lastname: Dreger
mesh_terms: D003245:Consensus Statements as Topic; D003697:Delphi Technique; D005060:Europe / Q000453:epidemiology; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000592:standards*; D006801:Humans; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery